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Get Wa Request For A Health District Construction Clearance And/or Water Supply Comment 2009

FOR A HEALTH DISTRICT CONSTRUCTION CLEARANCE AND/OR WATER SUPPLY COMMENT Property Tax Account Number Owners Name: Phone: Mail Address: City: Contact Person: Zip: Phone: Mail Address: City: SITE ADDRESS: Zip: CITY: SITE LEGAL DESCRIPTION AND LOT #: SP #/Plat name INSTALLED/EXISTING* Is Septic System/Drainfield: PROPOSED NOT APPLICABLE *If installed/existing, approximate year of installation Has a new onsite sewage disposal system application been made to the Snohomish Health Dis.

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